Craniofacial morphology in pediatric patients with Prader-Willi syndrome: a retrospective study.

OBJECTIVE: To investigate craniofacial characteristics in pediatric patients with Prader-Willi syndrome (PWS). SETTING AND SAMPLE POPULATION: A retrospective sample of 20 consecutive patients with PWS who had lateral and antero-posterior (AP) cephalograms (14 males and six females; average age 10.2 ± 3 years) was compared to 20 controls matched for age and sex (14 males and six females; average age 10.5 ± 3.7 years). MATERIALS AND METHODS: Cephalometric skeletal measurements were performed twice at a 1-week interval by one calibrated operator, and random error was calculated using Dahlberg's formula. Mean values and standard deviations were computed for all variables. Student's t-test for independent samples was used to determine significant differences between PWS and controls. The level of significance was set at p < 0.05. RESULTS: Cephalometric values for the length of the maxilla (p < 0.01), mandibular length (p < 0.05) at both the ramus (p < 0.05) and the mandibular body (p < 0.01), and posterior and anterior facial height (p < 0.01) were significantly lower in patients with PWS compared to controls. The AP cephalometric analysis revealed a significant reduction (p < 0.01) in maxillary skeletal width, mandibular skeletal width, and interzygomatic distance. CONCLUSIONS: Pediatric patients with PWS seem to have a general reduction in certain craniofacial skeletal parameters (i.e., maxillary and mandibular length) compared to controls, but this study did not assess the overall craniofacial characteristics.

Primary gastric tuberculosis presenting as pyloric outlet obstruction.

A 38-yr-old Haitian male with a longstanding history of peptic ulcer disease presented with persistent vomiting and weight loss. Barium studies and upper endoscopy revealed gastric outlet obstruction with prepyloric ulcerations. Endoscopic biopsies were consistent with chronic gastritis. The patient did not respond to intensive medical management, including total parenteral nutrition, intravenous cimetidine, and nasogastric suctioning. At the time of surgery, large celiac lymph nodes were noted surrounding the pylorus and the first portion of the duodenum. Biopsies of the wall of the stomach and lymph nodes demonstrated necrotizing granulomas. Cultures for acid-fast bacilli subsequently grew Mycobacterium tuberculosis. A search for foci outside the gastrointestinal tract was negative. Primary gastric tuberculosis remains an extremely uncommon clinical entity; the definitive diagnosis is made by biopsy and positive culture for the organism.

Serum antibodies to poliomyelitis in Italy.

A seroepidemiological survey was conducted to assess the effectiveness of the Italian nationwide immunization programme against poliomyelitis. Over 3800 serum samples were collected from persons, aged between 6 months and 79 years and residing in urban and rural areas with different socioeconomic conditions and geographic locations.A very high level of protection was found in the target population, confirming the almost 100% history of complete immunization. Almost all subjects over 30 years of age were found to have poliovirus antibodies, although they had never been vaccinated. In Naples, a higher proportion of subjects susceptible to all 3 types of virus was found in the age group 6-23 months, suggesting a delay in the administration of vaccine. This was confirmed by the analysis of the immunization history. No difference was observed between urban and rural areas, in either serological results or history of immunization.The results confirmed the higher immunogenicity of poliovirus type 2 with respect to the other two types, the effectiveness of the vaccine, and, finally, the efficiency of the operational procedures adopted for its administration.